Anemia Studies in Chronic Kidney Disease (CKD): Erythropoiesis Via a Novel Prolyl Hydroxylase Inhibitor (PHI) Daprodustat-in Incident Dialysis (ASCEND-ID)

A 52-week Open-label (Sponsor-blind), Randomized, Active-controlled, Parallel-group, Multi-center Study to Evaluate the Efficacy and Safety of Daprodustat Compared to Recombinant Human Erythropoietin in Subjects With Anemia Associated With Chronic Kidney Disease Who Are Initiating Dialysis

The purpose of this multi-center study is to evaluate the efficacy and safety of daprodustat in subjects with anemia associated with CKD.

Study Overview

• Status: Completed
• Conditions: Anaemia
• Intervention / Treatment: Drug: Daprodustat; Drug: Iron therapy; Drug: Darbepoetin alfa

• Study Type: Interventional
• Enrollment (Actual): 312
• Phase: Phase 3

Contacts and Locations

Study Locations

• Argentina
  • Buenos Aires, Argentina, 1425
    • GSK Investigational Site
  • Formosa, Argentina, P3600LLD
    • GSK Investigational Site
  • Mendoza, Argentina, M5500AFA
    • GSK Investigational Site
  • San Miguel de Tucumán, Argentina, T4000AHL
    • GSK Investigational Site
  • Buenos Aires
    • Ciudad Evita, Buenos Aires, Argentina, B1778IFA
      • GSK Investigational Site
    • La Plata, Buenos Aires, Argentina, B1902COS
      • GSK Investigational Site
    • Morón, Buenos Aires, Argentina, B1708DPO
      • GSK Investigational Site
    • Pergamino, Buenos Aires, Argentina, B2700CPM
      • GSK Investigational Site
    • Pilar, Buenos Aires, Argentina, 1629
      • GSK Investigational Site
• Australia
  • South Australia
    • Adelaide, South Australia, Australia, 5000
      • GSK Investigational Site
  • Victoria
    • Melbourne, Victoria, Australia, 3004
      • GSK Investigational Site
    • St Albans, Victoria, Australia, 3021
      • GSK Investigational Site
• Canada
  • Ontario
    • London, Ontario, Canada, N6A 5A5
      • GSK Investigational Site
    • Toronto, Ontario, Canada, M3M 0B2
      • GSK Investigational Site
  • Quebec
    • Greenfield Park, Quebec, Canada, J4V 2H1
      • GSK Investigational Site
• Germany
  • Wiesbaden, Germany, 65191
    • GSK Investigational Site
  • Nordrhein-Westfalen
    • Duesseldorf, Nordrhein-Westfalen, Germany, 40210
      • GSK Investigational Site
  • Rheinland-Pfalz
    • Kaiserslautern, Rheinland-Pfalz, Germany, 67655
      • GSK Investigational Site
• India
  • Bangalore, India, 560055
    • GSK Investigational Site
  • Chennai, India, 600037
    • GSK Investigational Site
  • Delhi, India, 110076
    • GSK Investigational Site
  • Gurgaon, India, 122001
    • GSK Investigational Site
  • Kozhikode, India, 673008
    • GSK Investigational Site
  • New Delhi, India, 110060
    • GSK Investigational Site
  • Pune, India, 411004
    • GSK Investigational Site
  • Secunderabad, India, 560020
    • GSK Investigational Site
  • Thiruvananthapuram, India, 695011
    • GSK Investigational Site
• Italy
  • Liguria
    • Genova, Liguria, Italy, 16132
      • GSK Investigational Site
  • Lombardia
    • Milano, Lombardia, Italy, 20153
      • GSK Investigational Site
    • Pavia, Lombardia, Italy, 27100
      • GSK Investigational Site
  • Sardegna
    • Cagliari, Sardegna, Italy, 09100
      • GSK Investigational Site
• Korea, Republic of
  • Anyang-Si, Gyeonggi-do, Korea, Republic of, 14068
    • GSK Investigational Site
  • Bucheon-si,, Korea, Republic of, 14647
    • GSK Investigational Site
  • Incheon, Korea, Republic of, 6510
    • GSK Investigational Site
  • Seoul, Korea, Republic of, 05030
    • GSK Investigational Site
  • Seoul, Korea, Republic of, 08308
    • GSK Investigational Site
  • Suwon, Korea, Republic of, 16499
    • GSK Investigational Site
• Malaysia
  • Ipoh, Malaysia, 30450
    • GSK Investigational Site
  • Kuala Lumpur, Malaysia, 59100
    • GSK Investigational Site
  • Penang, Malaysia, 10990
    • GSK Investigational Site
• Mexico
  • Aguascalientes, Mexico, 20259
    • GSK Investigational Site
  • Tlalnepantla, Mexico, 54055
    • GSK Investigational Site
  • Coahuila
    • Torreon, Coahuila, Mexico, 27000
      • GSK Investigational Site
  • Estado De México
    • Ciudad De México, Estado De México, Mexico, 14000
      • GSK Investigational Site
  • Jalisco
    • Guadalajara., Jalisco, Mexico, 44600
      • GSK Investigational Site
    • Zapopan, Jalisco, Mexico, 45030
      • GSK Investigational Site
  • Yucatán
    • Merida, Yucatán, Mexico, CP 97070
      • GSK Investigational Site
    • Mérida, Yucatán, Mexico, 97130
      • GSK Investigational Site
• Poland
  • Gdansk, Poland, 80-952
    • GSK Investigational Site
  • Kolo, Poland, 62-600
    • GSK Investigational Site
  • Krakow, Poland, 31-826
    • GSK Investigational Site
  • Lodz, Poland, 92-213
    • GSK Investigational Site
  • Lodz, Poland, 96-300
    • GSK Investigational Site
  • Ostroda, Poland, 14-100
    • GSK Investigational Site
  • Ostroleka, Poland, 7410
    • GSK Investigational Site
  • Szczecin, Poland, 70-780
    • GSK Investigational Site
• Russian Federation
  • Irkutsk, Russian Federation, 664049
    • GSK Investigational Site
  • Mytishchi, Russian Federation, 141007
    • GSK Investigational Site
  • Omsk, Russian Federation, 644112
    • GSK Investigational Site
  • Smolensk, Russian Federation, 214006
    • GSK Investigational Site
  • St-Petersburg, Russian Federation, 197110
    • GSK Investigational Site
  • St. Petersburg, Russian Federation, 196247
    • GSK Investigational Site
  • St. Petersburg, Russian Federation, 191104
    • GSK Investigational Site
  • St. Petersburg, Russian Federation, 194354
    • GSK Investigational Site
  • Volzhskiy, Russian Federation, 404120
    • GSK Investigational Site
• South Africa
  • Cape Town., South Africa, 7925
    • GSK Investigational Site
• Spain
  • Badalona, Spain, 08916
    • GSK Investigational Site
  • Barcelona, Spain, 08035
    • GSK Investigational Site
  • Madrid, Spain, 28040
    • GSK Investigational Site
  • Puerto Real, Spain, 11510
    • GSK Investigational Site
  • Sevilla, Spain, 41009
    • GSK Investigational Site
• United Kingdom
  • Birmingham, United Kingdom, B9 5SS
    • GSK Investigational Site
  • Doncaster, United Kingdom, DN2 5LT
    • GSK Investigational Site
  • London, United Kingdom, SE5 9RS
    • GSK Investigational Site
  • Middlesbrough, United Kingdom, TS4 3BW
    • GSK Investigational Site
• United States
  • California
    • Anaheim, California, United States, 92801
      • GSK Investigational Site
    • Cerritos, California, United States, 90703
      • GSK Investigational Site
    • Escondido, California, United States, 92025
      • GSK Investigational Site
    • Glendale, California, United States, 91204
      • GSK Investigational Site
    • La Palma, California, United States, 90623
      • GSK Investigational Site
    • Los Angeles, California, United States, 90095
      • GSK Investigational Site
    • Los Angeles, California, United States, 90022
      • GSK Investigational Site
    • Lynwood, California, United States, 90262
      • GSK Investigational Site
    • Sacramento, California, United States, 95825
      • GSK Investigational Site
    • Whittier, California, United States, 90603
      • GSK Investigational Site
  • Connecticut
    • Middlebury, Connecticut, United States, 06762
      • GSK Investigational Site
  • Florida
    • Coral Gables, Florida, United States, 33134
      • GSK Investigational Site
    • Miami, Florida, United States, 33126
      • GSK Investigational Site
    • Miami, Florida, United States, 33169
      • GSK Investigational Site
  • Georgia
    • Augusta, Georgia, United States, 30912
      • GSK Investigational Site
  • Illinois
    • Chicago, Illinois, United States, 60637
      • GSK Investigational Site
    • Crystal Lake, Illinois, United States, 60014
      • GSK Investigational Site
  • Indiana
    • Fort Wayne, Indiana, United States, 46804
      • GSK Investigational Site
    • Merrillville, Indiana, United States, 46410
      • GSK Investigational Site
    • Michigan City, Indiana, United States, 46360
      • GSK Investigational Site
  • Iowa
    • Iowa City, Iowa, United States, 52242
      • GSK Investigational Site
  • Louisiana
    • Baton Rouge, Louisiana, United States, 70809
      • GSK Investigational Site
    • New Orleans, Louisiana, United States, 70112
      • GSK Investigational Site
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • GSK Investigational Site
  • Mississippi
    • Jackson, Mississippi, United States, 39216
      • GSK Investigational Site
  • Missouri
    • Kansas City, Missouri, United States, 64111
      • GSK Investigational Site
    • Saint Louis, Missouri, United States, 63110
      • GSK Investigational Site
  • New York
    • Bronx, New York, United States, 10461
      • GSK Investigational Site
    • Brooklyn, New York, United States, 11203
      • GSK Investigational Site
    • Buffalo, New York, United States, 14215
      • GSK Investigational Site
    • Mineola, New York, United States, 11501
      • GSK Investigational Site
    • New York, New York, United States, 10029
      • GSK Investigational Site
  • Texas
    • Houston, Texas, United States, 77004
      • GSK Investigational Site
    • Lufkin, Texas, United States, 75904
      • GSK Investigational Site
    • San Antonio, Texas, United States, 78229
      • GSK Investigational Site
  • Virginia
    • Hampton, Virginia, United States, 23666
      • GSK Investigational Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 99 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18 to 99 years of age inclusive.
• Planning to start chronic dialysis within the next 6 weeks (from the date of the screening visit) OR have started and received dialysis (as specified below) for end-stage renal disease for a maximum of <=90 days immediately prior to randomization and is not expected to stop dialysis during the duration of the trial: HD >=2 times per week or PD >=4 times per week including incremental schedule; subjects on continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) are eligible.
• Hemoglobin concentration as measured by HemoCue (range inclusive): 8 to 10.5 g/dL (5-6.5 millimoles per liter [mmol/L]) at screening and 8-11.0 g/dL (5 to 6.8 mmol/L) at randomization.
• Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.

Exclusion Criteria:

• Planned living-related or living-unrelated kidney transplant during the study.
• Ferritin: <=100 nanograms per milliliter (ng/mL) (<=100 micrograms per liter [mcg/L]) at screening or after IV iron supplementation.
• Transferrin saturation (TSAT): <=20% at screening or after IV iron supplementation.
• Vitamin B12 (cobalamin): Below the lower limit of the reference range at screening or after vitamin B12 supplementation.
• Folate: <2.0 ng/mL (<4.5 nanomoles per liter [nmol/L]) at screening.
• Aplasias: History of bone marrow aplasia or pure red cell aplasia (PRCA).
• Other causes of anemia: Untreated pernicious anemia, thalassemia major, sickle cell disease, or myelodysplastic syndrome.
• Gastrointestinal (GI) bleeding: Evidence of actively bleeding gastric, duodenal, or esophageal ulcer disease or clinically significant GI bleeding <=10 weeks prior to screening through to randomization (Day 1).
• Use of any Erythropoiesis-stimulating agent (ESA) treatment within 8 weeks prior to screening except for limited use as part of dialysis initiation. Note : Limited use is defined as no more than 6 weeks of short acting ESA (rhEPO or biosimilars; maximum of 20000 unit total) or long acting ESA (darbepoetin alfa [maximum of 100 mcg total] or methoxy polyethylene glycol-epoetin beta [maximum of 125 mcg total]) received before or after starting dialysis.
• Myocardial infarction or acute coronary syndrome: <=10 weeks prior to screening through to randomization (Day 1).
• Stroke or transient ischemic attack: <=10 weeks prior to screening through to randomization (Day 1).
• Chronic Class IV heart failure, as defined by the New York Heart Association (NYHA) functional classification system.
• Current uncontrolled hypertension as determined by the Investigator that would contraindicate the use of rhEPO.
• QT correction using Bazett's (QTcB) (Day 1): QTcB >500 milliseconds (msec), or QTcB >530 msec in subjects with bundle branch block. There is no QTc exclusion for subjects with a predominantly ventricular paced rhythm.
• Liver disease (any one of the following): 1. Alanine transaminase (ALT) >2 times upper limit of normal (ULN) (screening only). 2. Bilirubin >1.5 times ULN (screening only) (NOTE: Isolated bilirubin >1.5 times ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). 3. Current unstable liver or biliary disease per investigator assessment, generally defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis. NOTE: Stable chronic liver disease (including asymptomatic gallstones, chronic hepatitis B or C, or Gilbert's syndrome) are acceptable if subject otherwise meets entry criteria.
• History of malignancy within the 2 years prior to screening through to randomization (Day 1), or currently receiving treatment for cancer, or complex kidney cyst (i.e. Bosniak Category II F, III or IV) >3 centimeter (cm). The only exception is localized squamous cell or basal cell carcinoma of the skin that has been definitively treated >=10 weeks prior to screening.
• History of severe allergic or anaphylactic reactions or hypersensitivity to excipients in the investigational product or to darbepoetin alfa.
• Use of strong Cytochrome P4502C8 (CYP2C8) inhibitors (example gemfibrozil) or strong CYP2C8 inducers (example rifampin/rifampicin).
• Use of other investigational agent or device prior to screening through to randomization (Day 1). At screening, this exclusion applies to use of the investigational agent within 30 days or within five half-lives (whichever is longer).
• Any prior treatment with daprodustat for treatment duration of >30 days.
• Females only: Subject is pregnant [as confirmed by a positive serum human chorionic gonadotropin (hCG) test for females of reproductive potential (FRP) only], subject is breastfeeding, or subject is of reproductive potential and does not agree to follow one of the contraceptive options in the List of Highly Effective Methods for Avoiding Pregnancy.
• Any other condition, clinical or laboratory abnormality, or examination finding that the investigator considers would put the subject at unacceptable risk, which may affect study compliance (example intolerance to rhEPO) or prevent understanding of the aims or investigational procedures or possible consequences of the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Daprodustat treated anemic subjects; Subjects will receive oral daprodustat once daily.	Drug: Daprodustat; Daprodustat will be supplied as film coated tablets for oral administration containing 1, 2, 4, 6, 8, or 10 mg of daprodustat. Doses of 12, 16, and 24 mg of daprodustat will be provided using multiples of these tablet strengths.; Drug: Iron therapy; Iron therapy will be administered if ferritin is <=100 ng/mL and/or TSAT is <=20%.
Active Comparator: Darbepoetin alfa treated anemic subjects; Subjects will receive darbepoetin alfa subcutaneously or intravenously.	Drug: Iron therapy; Iron therapy will be administered if ferritin is <=100 ng/mL and/or TSAT is <=20%.; Drug: Darbepoetin alfa; Darbepoetin alfa will be supplied as prefilled syringes (PFS) for SC/IV injection available in strengths: 20, 30, 40, 60, 80, 100 and 150 mcg.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean Change From Baseline in Hemoglobin (Hgb) During Evaluation Period (Week 28 to Week 52)	Blood samples were collected from participants for Hgb measurement. Hgb during the evaluation period was defined as the mean of all available post-randomization Hgb values (on and off-treatment) during the evaluation period (Week 28 to Week 52). For the primary analysis missing post-Baseline Hgb values were imputed using pre-specified multiple imputations. Change from Baseline was defined as the average of post-randomization values during the evaluation period minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date. An analysis of covariance (ANCOVA) model including randomization stratification factors Baseline Hgb and treatment was performed to obtain a point estimate and two-sided 95 percent (%) confidence interval (CI) for the treatment difference (daprodustat-darbepoetin alfa).	Baseline (Pre-dose on Day 1) and evaluation period (Week 28 to Week 52)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average Monthly Intravenous Iron Dose (Milligrams) From Baseline to Week 52	Total IV iron dose per participant was calculated from Day 1 to the earliest of (Week 52 visit date, first blood [red blood cells or whole blood] transfusion date and treatment stop date plus [+] 1 day) which corresponds to the time while the participant was on randomized treatment and before receiving a blood transfusion. Average monthly IV iron dose was calculated by Total IV iron dose divided by (/) (the number of days from Day 1 to the earliest of [Week 52 visit date, first blood transfusion date and treatment stop date +1] /30.4375 days). Data for participants until they underwent a red blood cells or whole blood transfusion was included in the analysis.	Baseline (Day 1) to Week 52
Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Blood Pressure (MAP) at Week 52	SBP, DBP and MAP were measured in a semi-supine or seated position in the dialysis chair after at least a 5-minutes of rest. MAP is an average BP in an individual's arteries during a single cardiac cycle. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date. This analysis was carried out by using mixed model repeated measures (MMRM) model.	Baseline (Day 1) and Week 52
Change From Baseline in SBP, DBP, MAP at End of Treatment	SBP, DBP and MAP were measured in a semi-supine or seated position in the dialysis chair after at least a 5-minutes of rest. MAP is an average BP in an individual's arteries during a single cardiac cycle. End of treatment value for the blood pressure parameters were defined as the latest value on or before the last non-zero dose date plus (+) 1 day. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date. This analysis was carried out by using ANCOVA model.	Baseline (Day 1) and end of treatment (last on-treatment value until Week 52)
Blood Pressure (BP) Exacerbation Events Rate Per 100 Participant Years	BP exacerbation event is defined (based on post-dialysis BP) as SBP >=25 millimeter of mercury (mmHg) increased from Baseline or SBP >=180 mmHg; or DBP >=15 mmHg increased from Baseline or DBP >=110 mmHg. The BP exacerbation events per 100 participant years was estimated using the Negative Binomial Model.	Up to Week 52
Number of Participants With at Least One Blood Pressure Exacerbation Event During Study	BP exacerbation was defined (based on post-dialysis BP) as: SBP >=25 mmHg increased from Baseline or SBP >=180 mmHg; DBP >=15 mmHg increased from Baseline or DBP >=110 mmHg. Number of participants with at least one blood pressure exacerbation event is presented.	Up to Week 52
Change From Baseline in Post-randomization Hgb at Week 52	Blood samples were collected from participants for Hgb measurements. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1) and Week 52
Number of Hgb Responders (Hgb in the Analysis Range of 10 to 11.5 Grams/Deciliter) During Evaluation Period (Week 28 to Week 52)	Mean Hgb during the evaluation period was defined as the mean of all evaluable Hgb values during the evaluation period (Week 28 to Week 52) including any evaluable unscheduled Hgb values that were taken during this time period. Hgb responders were defined as number of participants with a mean Hgb during the evaluation period that falls within the Hgb analysis range of 10-11.5 g/dL.	Weeks 28 to 52
Percentage of Time for Which Hgb Was Within the Analysis Range (10 to 11.5 g/dL) During Evaluation Period (Week 28 to Week 52): Non-inferiority Analysis	Percentage of days for which a participant's Hgb was within the analysis range of 10-11.5 g/dL (both inclusive) during the evaluation period (Week 28 to Week 52), including any unscheduled evaluable Hgb values that were taken during this time period was calculated. Percentage of time for which Hgb was within range for a participant was calculated by dividing 'the total number of days that Hgb was within range during Weeks 28 to 52' by 'the total number of days the participant remained on treatment during Weeks 28 to 52'.	Weeks 28 to 52
Percentage of Time for Which Hgb Was Within the Analysis Range (10 to 11.5 g/dL) During Evaluation Period (Week 28 to Week 52): Superiority Analysis	Percentage of days for which a participant's Hgb was within the analysis range of 10-11.5 g/dL (both inclusive) during the evaluation period (Week 28 to Week 52), including any unscheduled evaluable Hgb values that were taken during this time period was calculated. Percentage of time for which Hgb was within range for a participant was calculated by dividing 'the total number of days that Hgb was within range during Weeks 28 to 52' by 'the total number of days the participant remained on treatment during Weeks 28 to 52'.	Weeks 28 to 52
Number of Participants Permanently Stopping Randomized Treatment Due to Meeting Rescue Criteria	Number of participants permanently stopping randomized treatment due to meeting rescue criteria has been presented.	Up to Week 52
Change From Baseline in Physical Component Score (PCS) Using Short Form (SF)-36 Health-related Quality of Life (HRQoL) Questionnaire at Weeks 8, 12, 28, 52	The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following 8 health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality and general health. Each domain is scored from 0 (poorer health) to 100 (better health). The PCS is an average score derived from 4 domains (physical functioning, role-physical, bodily pain and general health) representing overall physical health. PCS ranges from 0 to 100; higher scores represent better health. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1), Weeks 8, 12, 28 and 52
Change From Baseline in Mental Component Score (MCS) Using SF-36 HRQoL Questionnaire at Weeks 8, 12, 28, 52	The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following 8 health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality and general health. Each domain is scored from 0 (poorer health) to 100 (better health). MCS is an average score derived from 4 domains (vitality, social functioning, role-emotional and mental health) representing overall mental health. MCS ranges from 0 to 100; higher scores represent better health. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1), Weeks 8, 12, 28 and 52
Change From Baseline in SF-36 HRQoL Scores for Bodily Pain, General Health, Mental Health, Role-Emotional, Role-Physical, Social Functioning at Weeks 8, 12, 28, 52	The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following 8 health domains: bodily pain, general health, mental health, role-emotional (role limitations caused by emotional problems), role-physical (role limitations caused by physical problems), social functioning, physical functioning and vitality. Each domain is scored from 0 (poorer health) to 100 (better health). Each domain score ranges from 0 to 100, higher score indicates a better health state and better functioning. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1), Weeks 8, 12, 28 and 52
Change From Baseline in Vitality Scores Using SF-36 HRQoL Questionnaire at Weeks 28, 52	The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following 8 health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality and general health. Each domain is scored from 0 (poorer health) to 100 (better health). Vitality ranges from 0 to 100; higher scores represent better health. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1), Weeks 28 and 52
Change From Baseline in Physical Functioning Domain Scores Using SF-36 HRQoL Questionnaire at Weeks 28, 52	The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following 8 health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality and general health. Each domain is scored from 0 (poorer health) to 100 (better health). Physical functioning ranges from 0 to 100; higher scores represent better health. Change from Baseline was calculated as post-dose visit value minus (-) Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1), Weeks 28 and 52
Change From Baseline in Health Utility EuroQol 5 Dimensions 5 Level (EQ-5D-5L) Questionnaire Score at Week 52	EQ-5D-5L consists of 2 concepts-EQ-5D-5L descriptive system and EQ Visual Analogue Scale (EQ-VAS). EQ-5D-5L is self-assessment questionnaire, consisting of 5items covering 5 dimensions (mobility,self care, usual activities, pain/discomfort and anxiety/depression). Each dimension is measured by 5-point Likert scale(no problems, slight problems, moderate problems, severe problems and extreme problems). Responses for 5 dimensions together formed a 5-figure description of health state(e.g.11111 indicates no problems in all 5 dimensions). Each of these 5 figure health states were converted to a single index score by applying country-specific value set formula that attaches weights to dimensions and levels. Range for EQ-5D-5L index score is -0.594 (worst health) to 1 (full health), higher the score better the health status. Change from Baseline was calculated as post-dose visit value-Baseline value. Baseline was latest non-missing pre-dose assessment on or before randomization date.	Baseline (Day 1) and Week 52
Change From Baseline in EQ Visual Analogue Scale (EQ-VAS) at Week 52	The EQ-5D-5L consists of 2 concepts -EQ-5D-5L descriptive system and EQ-VAS. The EQ-5D-5L is a self-assessment questionnaire, consisting of five items covering five dimensions (mobility, self care, usual activities, pain/discomfort and anxiety/depression). Each dimension is measured by a five-point Likert scale (no problems, slight problems, moderate problems, severe problems, and extreme problems). The range for the EQ-5D-5L index score is 0 to 1 with '0' is worst health and '1' is full health. The EQ VAS records the respondent's self-rated health on a vertical VAS, ranging from 0 to 100, where 0 represents the worst health one can imagine and 100 represents the best health one can imagine. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1) and Week 52
Change From Baseline in Chronic Kidney Disease- Anemia Symptoms Questionnaire (CKD-AQ) at Week 52	CKD-AQ is 21-item patient reported outcome measure assessing symptoms and symptom impact in participants with anemia associated with CKD. It had 3 domains: 1.Tired/Low Energy/Weak scale consisting of 10 items; 2.Chest Pain/Shortness of Breath scale consisting of 4 items; and 3.Cognitive scale consisting of 3 items. The 4 CKD-AQ single items are: (shortness of breath, no activity), (severity-short breath, resting), (difficulty standing for long time) and (difficulty sleeping). Single-item were recorded based on a 0-100 scoring with 0=worst possible and 100=best possible score. Three domains scores were calculated as average of items in each domain and ranged from 0-100 where 0=worst possible and 100=best possible score. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1) and Week 52
Change From Baseline in Patient Global Impression of Severity (PGI-S)	The PGI-S is a 1-item questionnaire designed to assess participant's impression of disease severity on a 5-point disease severity scale (0=absent, 1=mild, 2=moderate, 3=severe, or 4=very severe). A higher score indicated worse outcome. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline was defined as the latest non-missing pre-dose assessment on or before the randomization date.	Baseline (Day 1), Weeks 8, 12, 28 and 52
Plasma Concentration of Daprodustat (GSK1278863) and Its Metabolites GSK2391220 (M2), GSK2506104 (M3), and GSK2531401 (M13)	Pharmacokinetic samples were collected at pre-dose, 0.5, 1, 2 and 3 hours post-dose on Week 4 or 8 or 12 for pharmacokinetic (PK) analysis of daprodustat (GSK1278863) and its metabolites GSK2391220 (M2), GSK2506104 (M3), and GSK2531401 (M13). GSK2391220, GSK2506104 and GSK2531401 are the metabolites of Daprodustat (GSK1278863). Protocol allowed participants to provide pharmacokinetic samples on Week 4 or 8 or 12. Pharmacokinetic Population comprised of participants for whom a pharmacokinetic sample was obtained and analyzed.	Pre-dose, 0.5, 1, 2 and 3 hours post-dose; each pharmacokinetic sample was taken at Week 4 or 8 or 12
Observed Concentration at Dosing Interval (Ctau) of Daprodustat (GSK1278863) and Its Metabolites GSK2391220 (M2), GSK2506104 (M3), and GSK2531401 (M13)	Pharmacokinetic samples were collected at pre-dose, 0.5, 1, 2 and 3 hours post-dose on Week 4 or 8 or 12 for pharmacokinetic analysis of daprodustat (GSK1278863) and its metabolites GSK2391220 (M2), GSK2506104 (M3), and GSK2531401 (M13). GSK2391220, GSK2506104 and GSK2531401 are the metabolites of Daprodustat (GSK1278863). Protocol allowed participants to provide pharmacokinetic samples on Week 4 or 8 or 12.	Pre-Dose, 0.5, 1, 2 and 3 hours post-dose; each pharmacokinetic sample was taken at Week 4 or 8 or 12
Maximum Observed Concentration (Cmax) of Daprodustat (GSK1278863) and Its Metabolites GSK2391220 (M2), GSK2506104 (M3), and GSK2531401 (M13)	Pharmacokinetic samples were collected at pre-dose, 0.5, 1, 2 and 3 hours post-dose on Week 4 or 8 or 12 for pharmacokinetic analysis of daprodustat (GSK1278863) and its metabolites GSK2391220 (M2), GSK2506104 (M3), and GSK2531401 (M13). GSK2391220, GSK2506104 and GSK2531401 are the metabolites of Daprodustat (GSK1278863). Protocol allowed participants to provide pharmacokinetic samples on Week 4 or 8 or 12.	Pre-Dose, 0.5, 1, 2 and 3 hours post-dose; each pharmacokinetic sample was taken at Week 4 or 8 or 12

Collaborators and Investigators

• Sponsor: GlaxoSmithKline

Publications and helpful links

General Publications

• Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.
• Singh AK, Cizman B, Carroll K, McMurray JJV, Perkovic V, Jha V, Johansen KL, Lopes RD, Macdougall IC, Obrador GT, Waikar SS, Wanner C, Wheeler DC, Wiecek A, Stankus N, Strutz F, Blackorby A, Cobitz AR, Meadowcroft AM, Paul G, Ranganathan P, Sedani S, Solomon S. Efficacy and Safety of Daprodustat for Treatment of Anemia of Chronic Kidney Disease in Incident Dialysis Patients: A Randomized Clinical Trial. JAMA Intern Med. 2022 Jun 1;182(6):592-602. doi: 10.1001/jamainternmed.2022.0605.

Study record dates

Study Major Dates

• Study Start (Actual): May 11, 2017
• Primary Completion (Actual): September 24, 2020
• Study Completion (Actual): September 24, 2020

Study Registration Dates

• First Submitted: January 20, 2017
• First Submitted That Met QC Criteria: January 20, 2017
• First Posted (Estimate): January 24, 2017

Study Record Updates

• Last Update Posted (Actual): October 20, 2021
• Last Update Submitted That Met QC Criteria: September 22, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: Daprodustat, recombinant human erythropoietin, darbepoetin, anemia, chronic kidney disease, dialysis, ESRD
• Additional Relevant MeSH Terms: Urologic Diseases; Hematologic Diseases; Renal Insufficiency; Kidney Diseases; Renal Insufficiency, Chronic; Anemia; Hematinics; Darbepoetin alfa
• Other Study ID Numbers: 201410; 2016-000507-86 (EudraCT Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: IPD for this study will be made available via the Clinical Study Data Request site.
• IPD Sharing Time Frame: IPD will be made available within 6 months of publishing the results of the primary endpoints, key secondary endpoints and safety data of the study.
• IPD Sharing Access Criteria: Access is provided after a research proposal is submitted and has received approval from the Independent Review Panel and after a Data Sharing Agreement is in place. Access is provided for an initial period of 12 months but an extension can be granted, when justified, for up to another 12 months.
• IPD Sharing Supporting Information Type: Study Protocol; Statistical Analysis Plan (SAP); Informed Consent Form (ICF); Clinical Study Report (CSR)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No